Outcomes of acute myeloid leukemia patients who responded to venetoclax and azacitidine and stopped treatment.


Journal

American journal of hematology
ISSN: 1096-8652
Titre abrégé: Am J Hematol
Pays: United States
ID NLM: 7610369

Informations de publication

Date de publication:
20 Jun 2024
Historique:
revised: 29 04 2024
received: 05 02 2024
accepted: 30 05 2024
medline: 20 6 2024
pubmed: 20 6 2024
entrez: 20 6 2024
Statut: aheadofprint

Résumé

Venetoclax-azacitidine is the standard of treatment for unfit acute myeloid leukemia patients. In the VIALE-A study, treatment was given until progression but there are no data on its optimal duration for responding patients who do not tolerate indefinite therapy. We retrospectively analyzed the outcome of patients who discontinued venetoclax or venetoclax-azacitidine due to poor tolerance. Sixty-two newly diagnosed (ND) AML patients and 22 patients with morphological relapse or refractory AML were included. In the ND cohort (n = 62), 28 patients stopped venetoclax and azacitidine and 34 patients continued azacitidine monotherapy. With a median follow-up of 23 months (IQR, 20-32), median overall survival and treatment-free survival were 44 (IQR, 16-NR) and 16 (IQR, 8-27) months, respectively. Patients who stopped both treatments and those who continued azacitidine monotherapy had the same outcomes. Negative minimal residual disease was associated with a 2-year treatment-free survival of 80%. In the RR cohort (n = 22), median overall survival and treatment-free survival were 19 (IQR, 17-31) and 10 (IQR, 5-NR) months, respectively. Prior number of venetoclax-azacitidine cycles and IDH mutations were associated with increased overall survival. The only factor significantly impacting treatment-free survival was the number of prior cycles. This study suggests that patients who discontinued treatment in remission have favorable outcomes supporting the rationale for prospective controlled trials.

Identifiants

pubmed: 38899566
doi: 10.1002/ajh.27417
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Author(s). American Journal of Hematology published by Wiley Periodicals LLC.

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Auteurs

Sylvain Garciaz (S)

Département d'hématologie, Institut Paoli-Calmettes, Université d'Aix-Marseille, INSERM U1068, CNRS, Marseille, France.

Pierre-Yves Dumas (PY)

CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France.
BRIC (BoRdeaux Institute of onCology), UMR1312, INSERM, Université de Bordeaux, Bordeaux, France.

Sarah Bertoli (S)

Service d'hématologie, Centre Hospitalo-universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, UPS, Service d'hématologie, Toulouse, France.

David A Sallman (DA)

Malignant Hematology Department, H. Lee Moffitt Cancer Center, Tampa, Florida, USA.

Justine Decroocq (J)

Département d'hématologie, Hôpital Cochin, APHP, Paris, France.

Amine Belhabri (A)

Département d'hématologie, Centre Léon Bérard, Centre de Recherche en Cancerologie de Lyon (CRCL) UMR INSERM 1052, CNRS 5286, Lyon, France.

Corentin Orvain (C)

Maladies du Sang, CHU d'Angers, Angers, France.
Fédération Hospitalo-Universitaire Grand-Ouest Acute Leukemia, FHU-GOAL, Angers, France.
Université d'Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCI2NA, Angers, France.

Gaspar Aspas Requena (G)

Département d'hématologie, CHU Clermont-Ferrand, Clermont-Ferrand, France.

Celestine Simand (C)

Département d'hématologie, ICANS (Institut for Cancer Strasbourg-Europe), Strasbourg, France.

Kamel Laribi (K)

Département d'hématologie, CH Le Mans, Le Mans, France.

Martin Carré (M)

Département d'hématologie, CHU de Grenoble, Grenoble, France.

Alberto Santagostino (A)

Département d'hématologie, CH Troyes, Troyes, France.

Chantal Himberlin (C)

Département d'hématologie, CHU Reims, Reims, France.

Pierre Peterlin (P)

Département d'hématologie, CHU Nantes, Nantes, France.

Sarah Bonnet (S)

Département d'Hématologie Clinique, CHRU Montpellier, Montpellier, France.

Onyee Chan (O)

Malignant Hematology Department, H. Lee Moffitt Cancer Center, Tampa, Florida, USA.

Jeffrey Lancet (J)

Malignant Hematology Department, H. Lee Moffitt Cancer Center, Tampa, Florida, USA.

Rami Komrokji (R)

Malignant Hematology Department, H. Lee Moffitt Cancer Center, Tampa, Florida, USA.

François Vergez (F)

Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Laboratoire d'Hématologie, Toulouse, France.

Nicolas Chapuis (N)

Assistance Publique-Hôpitaux de Paris, Centre-Université Paris Cité, Service d'hématologie biologique, Hôpital Cochin, Paris, France.

Tatiana Raskovalova (T)

Laboratoire d'Immunologie, Grenoble University Hospital, Grenoble, France.
Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Université Grenoble Alpes, Grenoble, France.

Adriana Plesa (A)

Laboratoire de cytologie et d'immunologie, Lyon-Sud Hospital, Hospices Civils de Lyon, Pierre Bénite, France.

Anne-Catherine Lhoumeau (AC)

Département de Biologie du Cancer, Institut Paoli-Calmettes, Université d'Aix-Marseille, INSERM U1068, CNRS, Marseille, France.

Ariane Mineur (A)

CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France.
BRIC (BoRdeaux Institute of onCology), UMR1312, INSERM, Université de Bordeaux, Bordeaux, France.

Marie Anne Hospital (MA)

Département d'hématologie, Institut Paoli-Calmettes, Université d'Aix-Marseille, INSERM U1068, CNRS, Marseille, France.

Arnaud Pigneux (A)

CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France.
BRIC (BoRdeaux Institute of onCology), UMR1312, INSERM, Université de Bordeaux, Bordeaux, France.

Norbert Vey (N)

Département d'hématologie, Institut Paoli-Calmettes, Université d'Aix-Marseille, INSERM U1068, CNRS, Marseille, France.

Christian Récher (C)

Service d'hématologie, Centre Hospitalo-universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, UPS, Service d'hématologie, Toulouse, France.

Classifications MeSH